Blog

What strategies are in your arsenal to combat and conquer the thorny challenges of healthcare reform? Reducing costs? Improving quality, productivity and efficiency? Redesigning processes? Strengthening relationships with key stakeholders? Entering into new collaborative arrangements? Improving the patient experience? Transforming your organization from one that delivers episodic sick care to one that nurtures wellness and personal responsibility is daunting, but absolutely necessary.

What may seem like new challenges for the C-suite are, in reality, the same issues that have perplexed healthcare executives for years. While consultants have prospered by touting the “solution-of-the-day,” a handful of approaches have gained traction. One of those is clinical integration.

Just as healthcare continues to evolve, the concept of clinical integration also is maturing. Today’s focus on efficiency, cost effectiveness and quality has put coordination and collaboration at center stage. In fact, visionary healthcare organizations are realizing that integration of services and care requires a macro approach. That’s why many are pursuing a strategic path toward operational integration.

What is Operational Integration?

The concept of operational integration springs from the philosophy of clinical integration that traces its roots to cost containment efforts of the 1980s and 90s. In 1996, the Federal Trade Commission (FTC) defined clinical integration by establishing the legal parameters within which greater physician-hospital alignment could occur. The American Medical Association has defined clinical integration as “the means to facilitate the coordination of patient care across conditions, providers, settings and time in order to achieve care that is safe, timely, effective, efficient, equitable and patient-focused.”1

In a January 15, 2013 presentation to the American Hospital Association’s Physician Leadership Forum, Integrated Healthcare Strategies™, a healthcare consulting firm, defined organizational integration as “not just structural, but operational synchronization of services to provide optimal, efficient, effective patient-centered care.”

The Affordable Care Act of 2011 and the Institute for Health Improvement’s Triple Aim framework have accelerated the development of organizational integration with the emphasis on coordination across the entire episode of care through collaboration and non-traditional partnerships.

The concept and importance of integrated health services is a global phenomenon. The World Health Organization defines integrated service delivery as “the organization and management of health services so that people get the care they need, when they need it, in ways that are user-friendly, achieve the desired results and provide value for money.”2

Building a Highly-Integrated Organization

Most CEOs have a common vision for their organization – a future state where patients receive the highest quality care in a highly satisfying environment in the most cost-effective manner. But, as most healthcare leaders have discovered, culture trumps vision and the norms within the culture can make or break efforts to achieve the vision. Carefully plotting a roadmap that leads your organization to organizational integration is critical. Six key influencers determine, to a large extent, the degree of success a hospital or health system will enjoy:

Cultural readiness
Physician alignment and leadership development
Identification of waste and eliminating it wherever it exists in the organization
Alignment of processes and demolition of silos horizontally and vertically across the organization
Clear, concise communication between patients, physicians, staff and hospital employees
Elimination of variance and adherence to consistency in care delivery and operational processes to increase patient safety and reduce costs